Anthropometric, hormonal and metabolic changes in prepubertal children born as SGA (small for gestational age), with decreased growth, treated with the growth hormone, after the first year of therapy
Authors:
Ľ. Košťálová 1; I. Lacková 2; Z. Pribilincová 1; Z. Blusková 1
Authors place of work:
2. detská klinika LFUK a DFNsP Bratislavaprednosta prof. MUDr. L. Kovács, DrSc., MPH
1; Detsko-dojčenské oddelenie NsP, Myjava
2
Published in the journal:
Čes-slov Pediat 2014; 69 (2): 106-113.
Category:
Original Papers
Summary
Objective:
The aim of the work was to evaluate selected anthropometric, hormonal and metabolic parameters in SGA children, having been treated with the growth hormone and evaluated after the first year of therapy. The extent of success and risk of the treatment were to be evaluated.
Methods:
In SGA-born children, having been treated with the growth hormone in the endocrinology out-patient of the 2nd Children Clinic, Children Faculty Hospital (DFNsP) and Medical Faculty, Komensky University (LFUK) in Bratislava, the authors recorded and evaluated retrospectively their stature, BMI, blood sugar, fT4, TSH and IGF-1 just before the therapy and after one year of treatment with the growth hormone.
Results:
The study encompassed 45 prepubertal children (15 girls, mean age 9.1±3.1 year and 30 boys, mean age 8.9±3.6 years). The stature improved in boys on the average from -2.80±0.34 SDS to -2.27±0.45 SDS, p<0.001 in girls and from -2.92±0.48 SDS to -2.45±0.76 SDS, p<0.001 in boys. The BMI values remains without significant change. In both sexes, the levels of IGF-1 increased significantly (p<0.001), to a three-fold levels. The changes in the mean values of glucose, fT4 and TSH were not statistically significant.
Conclusion:
The positive influence of the therapy with growth hormone on stature and IGF-1 has been unequivocally proved in the treated children. The authors also conclude that the growth hormone has not significantly influenced the blood sugar and thyroid hormones in blood. All children included in the study proved to tolerate the therapy well and no side effects of the treatment were observed.
Key words:
SGA, growth hormone, hormonal and metabolic changes
Zdroje
1. Clayton PE, Cianfarani S, Czernichow P, et al. Management of the child born small for gestational age through to adulthood: a consensus statement of the International Societies of Pediatric Endocrinology and the Growth Hormone Research Society. J Clin Endocrinol Metab 2007; 92: 804–810.
2. Saenger P, Czernichov P, Hughes I, et al. Small for gestational age: Short stature and beyond. J Clin Endocrinol Metab 2007; 28: 219–257.
3. Lee PA, Chernausek SD, Hokken-Koelega AC, et al. International small for gestational age advisory board consensus development conference statement: management of short children born small for gestational age. Pediatrics 2003; 111: 1253–1261.
4. Kytnarová J, Zlatohlávková B, Fedorová M, et al. Intrauterinní růstová retardace a fetální původ chorob v dospělosti. Čes-slov Pediat 2008; 63: 320–326.
5. Blusková Z, Košťálová Ľ. Prenatálne a neonatálne prostredie a ich dôsledky na vývoj dieťaťa. Čes-slov Pediat 2012; 67: 253–259.
6. Košťálová Ľ. Liečba rastovým hormónom v detskom veku. Pediatr Prax 2008; 4: 207–211.
7. Kolektív autorov: Telesný vývoj detí a mládeže v SR. Výsledky VI. Celoštátneho prieskumu v roku 2001. Bratislava: Úrad verejného zdravotníctva SR, 2004.
8. Jancevska A, Tasic V, Damcevski N, et al. Children born small for gestational age (SGA). Prilozi 2012; 33: 47–58.
9. Bryan SM, Hindmarsh PC. Normal and abnormal fetal growth. Horm Res 2006; 65: 19–27.
10. Boguszewski M, Albertsson-Wikland K, Aronsson S, et al. Growth hormone treatment of short children born small-for-gestational-age: the Nordic Multicentre Trial. Acta Paediatr 1998; 87: 257–263.
11. Lee PA, Sävendahl L, Oliver I, et al. Comparison of response to 2-years‘ growth hormone treatment in children with isolated growth hormone deficiency, born small for gestational age, idiopathic short stature, or multiple pituitary hormone deficiency: combined results from two large observational studies. Int J Pediatr Endocrinol 2012; 1: 22.
12. Sas T, De Waal W, Mulder P, et al. Growth hormone treatment in children with short stature born small for gestational age: 5-year results of a randomized, double-blind, dose-response trial. J Clin Endocrinol Metab 1999; 84: 3064–3069.
13. Van Pareren Y, Mulder P, Houdijk M, et al. Adult height after long-term, continuous growth hormone (GH) treatment in short children born small for gestational age: Results of randomized, double-blind, dose-response GH trial. J Clin Endocrinol Metab 2003; 88: 3584–3590.
14. De Zegher F, Albertsson-Wikland K, Wollmann HA, et al. Growth hormone treatment of short children born small for gestational age: Growth responses with continuous and discontinuous regimens over 6 years. J Clin Endocrinol Metab 2000; 85: 2816–2820.
15. Van Dijk M, Bannink EMN, Van Pareren YK, et al. Risk factors for diabetes mellitus type 2 and metabolic syndrome are comparable for previously growth hormone-treated young adults born small for gestational age (SGA) and untreated short SGA controls. J Clin Endocrinol Metab 2007; 92: 160–165.
16. Argente J, Gracia R, Ibáñez L, et al. Improvement in growth after two years of growth hormone therapy in very young children born small for gestational age an without spontaneous catch-up growth: Results of a multicenter, controllen, randomized, open clinical trial. J Clin Endocrinol Metab 2010; 92: 3095–3101.
17. Bachmann S, Bechtold S, Bonfig W, et al. Insulin sensitivity decreases in short children born small for gestational age treated with growth hormone. J Pediatr 2009; 154: 509–513.
18. Cutfield WS, Jackson WE, Jefferies C, et al. Reduced insulin sensitivity during growth hormone therapy for short children born small for gestational age. J Pediatr 2003; 142: 113.
19. Lebl J, Lebenthal Y, Kolouskova S, et al. Metabolic impact of growth hormone treatment in short children born small for gestational age. Horm Res Paediatr 2011; 76: 254–261.
20. van Pareren Y, Mulder P, Houdijk M, et al. Effect of discontinuation of growth hormone treatment on risk factors for cardiovascular disease in adolescents born small for gestational age. J Clin Endocrinol Metab 2003; 88: 347–353.
21. Willemsen RH, Willemsen SP, Hokken-Koelega AC. Longitudinal changes in insulin sensitivity and body composition of small-for-gestational-age adolescents after cessation of growth hormone treatment. J Clin Endocrinol Metab 2008; 93: 3449–3454.
22. Güemes Hidalgo M, Fernández de Larrea Baz N, Muñoz Calvo MT, Argente J. Response to 3 years of growth hormone therapy in small for gestational age children: clinical, hormonal and metabolic parameters. An Pediatr (Barc) 2013; 78: 288–296.
23. Radetti G, Renzullo L, Gottardi E, et al. Altered thyroid and adrenal function in children born at term and preterm, small for gestational age. J Clin Endocrinol Metab 2004; 89: 6320–6324.
24. Jørgensen JO, Ovesen P, Juul A, et al. Impact of growth hormone administration on other hormonal axes. Horm Res 1999; 51: 121–126.
25. Lem AJ, de Rijke YB, van Toor H, et al. Serum thyroid hormone levels in healthy children from birth to adulthood and in short children born small for gestational age. J Clin Endocrinol Metab 2012; 97: 3170–3178.
26. de Kort SW, Willemsen RH, van der Kaay DC, et al. Thyroid function in short children born small-for-gestational age (SGA) before and during GH treatment. Clin Endocrinol (Oxf) 2008; 69: 318–322.
Štítky
Neonatology Paediatrics General practitioner for children and adolescentsČlánok vyšiel v časopise
Czech-Slovak Pediatrics
2014 Číslo 2
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- The Importance of Limosilactobacillus reuteri in Administration to Diabetics with Gingivitis
Najčítanejšie v tomto čísle
- Complications of surgical treatment of hydrocephalus
- The results of expanded newborn screening in the Czech Republic
- Osteogenesis imperfecta associated with isolated growth hormone deficiency
- Anthropometric, hormonal and metabolic changes in prepubertal children born as SGA (small for gestational age), with decreased growth, treated with the growth hormone, after the first year of therapy